Wednesday, January 16, 2019

2016 RCMA Annual Report

November 2016 Ballot Initiatives

CMA’s Board of Trustees has approved positions on several ballot measures for the November 2016 election

Prop. 52: California Medi-Cal Hospital Reimbursement Initiative
Position: CMA Supports
Prop. 52 would lock in hospital fees to allow the state to draw down federal health care funds. It would add language to the California Constitution requiring voter approval of changes to the hospital fee program. This will prevent diversion of the funds from the original intended purpose of supporting hospital care to Medi-Cal patients and paying for health care for low-income children.

Prop. 53: California Public Vote on Bonds Initiative
Position: CMA Opposes
Prop. 53 would require voter approval before the state could issue more than $2 billion in public infrastructure bonds that would require an increase in taxes or fees for repayment. This initiative could impact medical care by curtailing the ability of the State of California and local government entities to build or rebuild major infrastructure projects.

Prop. 55: California Children’s Education and Health Care Protection Act of 2016
Position: CMA Supports
Prop. 55 would extend the current income tax rates on the wealthiest two percent of Californians – singles earning more than $250,000 and couples earning more than $500,000 a year – for 12 years. Funding would provide local school districts the money needed to hire teachers and reduce class sizes and improve access to health care services for low-income children so they can stay healthy and thrive.

Prop. 56: California Healthcare, Research and Prevention Tobacco Tax Act of 2016
Position: CMA Supports
Prop. 56 – supported by a broad alliance of physicians, health care advocates, educators and others – would raise California’s tobacco tax, which is currently among the lowest in the country, to $2.87 a pack. Designed as a user fee on cigarettes and other tobacco products, the majority of the money would be used for existing health programs and research into cures for cancer and other illnesses caused by smoking and tobacco products.

Prop. 58: The Language Education Acquisition and Readiness Now (LEARN) Initiative
Position: CMA Supports
Prop. 58 would give local school districts and their academic staff the option of providing bilingual education. California needs a well-prepared and educated health care workforce that reflects our diverse society. Prop. 58 would break down barriers by removing outdated mandates, helping physicians provide the best patient care for all Californians.

Prop. 61: Drug Price Standards Initiative
Position: CMA Opposes
Prop. 61 would prevent certain state agencies from entering into contracts for the purchase of prescription drugs unless the price paid is the same as or lower than the special discounts provided to the U.S. Department of Veterans Affairs. The measure could result in the invalidation of existing agreements between the state and pharmaceutical companies that already provide significant discounts to the state.

Prop. 63: Safety for All Act of 2016
Position: CMA Supports
Prop. 63 would prohibit the possession of large-capacity ammunition magazines and would require most individuals to pass a background check and obtain authorization from the California Department of Justice to purchase ammunition. CMA supports Prop. 63 to ensure our communities are safe and healthy places to live.

Prop. 64: Adult Use of Marijuana Act
Position: CMA Supports
Prop. 64 would regulate and control the cultivation and use of non-medical cannabis. The proposal would generate up to $1 billion in taxes for state and local governments, according to a fiscal analysis of the proposal. CMA believes that the most effective way to protect public health is to tightly control, track and regulate cannabis, as well as comprehensively research and educate the public on its health impacts.

2016 RCMA Annual Outstanding Contribution Awards

CALL FOR NOMINATIONS: The RCMA is soliciting nominations to recognize and honor deserving individuals for the 2016 Annual Outstanding Contributions Awards. Nominations will be screened by the Awards Committee, with final selection determined by the Board of Councilors. The awards will be presented at the RCMA Installation of Officers Dinner on Friday, January 27, 2017.

Make A Nomination



  • Outstanding Contribution to Organized Medicine: Presented to a RCMA member who through his/her constant support and perpetual service has advanced and achieved the goals of organized medicine.
  • Outstanding Contribution to Medicine: Presented to a RCMA member who has displayed dedication to the advancement and improvement of the medical profession through his/her tireless efforts, innovative ideas and commitment to excellence.
  • Outstanding Contribution to the Medical Association and Its Goals: Presented to a RCMA member who has exhibited long-standing dedication and service to the RCMA over and above that expected by the membership-at-large.
  • Outstanding Contribution to the Community: Presented to a physician or lay person who has exhibited sustained interest and participation in one or more medicine-related activities which has benefited the members of his/her community.

Make A Nomination

California State Budget Update

Today, the Governor and legislative leaders announced an agreement on the 2015-16 State Budget Act and have settled the major issues and spending priority differences between the administration and the Legislative branch. A few key points and dollar amounts for the budget year include:

  •   $40 million to expand Medi-Cal to cover all low-income undocumented children effective May 1, 2016 ($132 million when fully implemented)
  • $265 million to fund 7,000 additional preschool slots and 6,800 child care slots, plus a rate increase for all providers.
  • $97 million over the January budget for the California State University to expand enrollment and focus on increased success.
  • $226 million on a one-time basis to restore the 7 percent reduction in service hours for In-Home Supportive Services.
The budget bills that will be voted on over the next several days will not contain an increase to Medi-Cal Provider Reimbursement rates. In a typical year, the conclusion of budget negotiations would mean the end of our hopes of improving access for over 12 million Californians who rely on the Medi-Cal program for the next 12 months.

However, the Governor made an additional important announcement this afternoon – he is calling a Special Session of the Legislature to address “Health Care Financing,” i.e. the Medi-Cal program. He specifically called for the need to address the budget hole created by the failure to pass a new managed care organization (MCO) tax and called on the Legislature to enact a permanent and sustainable funding source to fund “additional rate increases for providers of Medi-Cal and developmental disability services.” If you recall, since 2005, the state has had some form of a tax on managed care plans used to fund payments to Medi-Cal providers and reduce the state’s general fund exposure while drawing down federal matching funds. However, recently the federal government found California’s MCO tax structure fails to comply with new federal requirements that such a tax be broad-based and not limited narrowly to Medicaid plans. In his January budget, the Governor proposed a new MCO tax that conforms with the new federal requirements, however the Legislature did not adopt the proposal largely due to objections from health plans. In response, the Governor is proposing that the Legislature enact permanent and sustainable funding to provide at least $1.1 billion annually to the Medi-Cal program. His announcement states the funding could come from an MCO tax and/or alternative sources in the special session, such as a tax on tobacco products.

While the failure to address provider rates in the state budget is regrettable, the special session of the Legislature provides a new opportunity for RCMA/CMA and other stakeholders to push through a permanent and significant funding increase dedicated almost exclusively to providers of health care services and ensure the health care infrastructure exists to care for the Medi-Cal population. The Governor’s special session announcement was made on the same day, perhaps coincidentally, that the State Auditor released a report finding Medi-Cal managed care provider networks are severely lacking integrity and are resulting in barriers to accessing care. The State Auditor found that not only were managed care plans providing the state with inaccurate data on availability and participation of in-network physicians, it found the state was not verifying whether the data from the plans was accurate, and thus could not reliably determine whether the Medi-Cal networks meet California’s stringent network adequacy standards. A summary of the audit’s findings can be found at this link here.

The announcement of the special session allows the Governor and legislative leaders to bypass the traditional legislative and budgetary calendar. RCMA/CMA continues to work with its legislative allies and coalitions to push this issue over the finish line.

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